Occupational allergic contact dermatitis due to ethylenediamine dihydrochloride and cresyl glycidyl ether in epoxy resin systems

Contact allergy to epoxy hardeners

BACKGROUND

Diglycidylether of bisphenol A resin is the most important sensitizer in epoxy systems, but a minority of patients develop concomitant or solitary contact allergy to epoxy hardeners. At the Finnish Institute of Occupational Health, several in-house test substances of epoxy hardeners have been tested in a special epoxy compound patch test series.

OBJECTIVES

To analyse the frequency and clinical relevance of allergic reactions to different epoxy hardeners.

METHODS

Test files (January 1991 to March 2013) were screened for contact allergy to different epoxy hardeners, and the clinical records of patients with allergic reactions were analysed for occupation, concomitant allergic reactions, and exposure.

RESULTS

The most commonly positive epoxy hardeners were m-xylylenediamine (n = 24), 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP; n = 14), isophorone-diamine (n = 12), and diethylenetriamine (n = 9). Trimethylhexamethylenediamine (n = 7), tetraethylenepentamine (n = 4), and triethylenetetramine (n = 2) elicited some reactions, although most patients were found to have no specific exposure. Allergic reactions to hexamethylenetetramine, dimethylaminopropylamine and ethylenediamine dihydrochloride were not related to epoxy products.

CONCLUSIONS

Tris-DMP is an important sensitizer in epoxy hardeners, and should be included in the patch test series of epoxy chemicals.

An attempt to improve diagnostics of contact allergy due to epoxy resin systems. First results of the multicentre study EPOX 2002

Epoxy resin systems (ERSs) are a frequent cause of occupational allergic contact dermatitis. Sensitization occurs not only to the resins, but also to hardeners and reactive diluents. However, only a fraction of the ERS components currently in use are available for patch testing. With the multicentre study EPOX 2002, we attempted to improve diagnostics in this field by patch testing with components currently used in ERSs. During the first study period (October 2002 to July 2003), in addition to commercially available ERS patch test substances, 16 study substances (1 resin, 9 hardeners and 6 reactive diluents) were patch tested in 70 patients with suspected contact allergy due to ERSs and 22 patients with a prior positive patch test reaction to epoxy resin (ER) in the standard series. Most frequently, allergic reactions to ER based on diglycidyl ether of bisphenol A and F were observed (55.2% and 43.7%, respectively). Agreement between positive reactions to both resins, which can be explained by immunological cross-sensitization and/or coexposure, was substantial [Cohen's kappa 0.65 (95% CI: 0.49-0.80)]. Among the reactive diluents, 1,6-hexanediol diglycidyl ether (1,6-HDDGE) and 1,4-butanediol diglycidyl ether (1,4-BDDGE) were the most frequent allergens, with 19.5% and 18.4% positive reactions, respectively. Although agreement between positive reactions to 1,6-HDDGE and 1,4-BDDGE was even better than with the 2 resins, the sample size is considered too small to decide reliably whether 1,6-HDDGE alone could serve as a marker allergen for both. Allergic reactions to p-tert-butylphenyl glycidyl ether and to phenyl glycidyl ether (PGE) occurred in 11.5% of the patients tested, with only moderate agreement. All patients positive to cresyl glycidyl ether (6.8%) also reacted to PGE. Of the hardeners tested, m-xylylene diamine was the most frequent allergen (13.8%), followed by isophorone diamine (5.7%). No reactions were observed to several substances, the test concentration of which may have been too low and will be increased in the future.

An epidemic of occupational contact dermatitis from an immersion oil for microscopy in laboratory personnel

Since November 1997, 14 successive cases of occupational contact dermatitis were observed in 13 laboratory technicians and 1 physician, working in a genetics laboratory in Leuven (Belgium) in 3 laboratories of bacteriology in Strasbourg, Montbeliard and Angers, and in the laboratory of hematology in Bordeaux (France). The dermatitis, located on the hands, forearms and face, relapsed after each exposure to an immersion oil for microscopy. Patch tests performed in 10 patients were positive to epoxy resin (ER) in the European standard series (10/10 patients) and to newly formulated Leica immersion oil (7/7), 1 patient testing negatively with the former oil. A breakdown performed in 2 patients with the oil's ingredients confirmed sensitization to liquid modified ER components, contained at >80% concentration in the oil. The presence of DGEBA was demonstrated by HPLC analysis at a +/-30% rate. Although the safety data sheet indicated a revision of the formula, nobody was alerted to the risk of sensitization and the need for skin protection. ERs, as a source of occupational allergy, can provoke epidemics of contact dermatitis in industry. This report of epidemic contact dermatitis from ERs, used for their optical properties in an immersion oil for microscopy, emphasizes the need for perpetual vigilance in occupational medicine and the usefulness of multicentre contacts in dermato-allergology.

Urinary metabolite profile of phenyl and o-cresyl glycidyl ether in rats: identification of a novel pathway leading to N-acetylserine O-conjugates

The urinary excretion of metabolites of phenyl glycidyl ether (PGE) and o-cresyl glycidyl ether (o-CGE) was investigated in rats. Urine was collected, in fractions, from rats intraperitoneally administered PGE or o-CGE in doses ranging from 0.033 to 1.0 mmol/kg. The metabolites were extracted from acidified urine with ethyl acetate or diethyl ether, and their identity was elucidated by GC/MS analysis. The epoxide of PGE can be inactivated by glutathione (GSH) conjugation or epoxide hydrolysis. After further metabolism, these routes lead to the urinary excretion of phenyl glycidyl ether mercapturic acid (PGEMA) and 3-(phenyloxy)lactic acid (POLA). The excretion of PGEMA and POLA was described before and is confirmed in this study. Additionally, a new metabolite was identified as N-acetyl-O-phenylserine (NAPS), which is proposed to be formed from POLA by subsequent oxidation, transamination, and N-acetylation. For PGEMA a linear dose-excretion relationship was found (r2 = 0.988), and the percentage of the dose excreted declined from 27% to 10% with increasing PGE dose. For NAPS also a linear dose-excretion relationship was found (r2 = 0.985), and NAPS accounted for 27% of the PGE dose. The excretion of PGEMA and NAPS was rather fast: 93% and 75%, respectively, of the respective total cumulative amounts excreted was already collected within 6 h after administration. The urinary metabolite profile of o-CGE was not investigated in rats before. Three urinary metabolites of o-CGE were identified, namely, 3-(o-cresyloxy)lactic acid (COLA), o-cresyl glycidyl ether mercapturic acid (o-CGEMA), and N-acetyl-O-(o-cresyl)serine (NACS), showing that the metabolite profiles of PGE and o-CGE are comparable. Up to a o-CGE dose of 0.333 mmol/kg, the excretion of o-CGEMA was linear (r2 = 0.997), while above this dose the excretion did not increase anymore. The percentage of the o-CGE dose excreted as o-CGEMA declined from 31% to 11% with increasing dose. Again 93% of the total cumulative amount of o-CGEMA excreted was collected within 6 h after administration of o-CGE. Analytical methods were developed for the quantitative determination of mercapturic acid metabolites of PGE and o-CGE. These methods were sufficiently sensitive for their determination in urine of rats administered PGE or o-CGE in the dose range applied. It is anticipated that the analytical methods developed are also sufficiently sensitive to investigate excretion of the mercapturic acid metabolites in humans occupationally exposed to low air concentrations (<6 mg/m3 of air, 8h-TWA) of PGE or o-CGE.

Occupational allergic contact dermatitis caused by 2,4,6-tris-(dimethylaminomethyl)phenol, and review of sensitizing epoxy resin hardeners

BACKGROUND

Epoxy resin compounds (ERC) include a large number of sensitizing chemicals such as epoxy resins (ER), hardeners (curing agents), and reactive diluents. Allergic contact dermatitis (ACD) caused by ERCS is often occupational.

MATERIALS AND METHODS

We report a patient, sensitized to a hardener of a two-component epoxy paint. Three conventional patch test sessions were performed to diagnose the causative chemical. We also review the literature on sensitizing epoxy-resin hardeners.

RESULTS

A 47-year-old nonatopic woman developed dermatitis from a two-component epoxy paint. Patch testing with epoxy resin was negative, but 2,4,6-tris(dimethylaminomethyl)phenol (tris-DMP), used in the paint hardener, induced an allergic patch test reaction. We also review briefly other epoxy hardeners that have caused allergic dermatitis, including: (1) aliphatic polyamines, e.g., ethylenediamine, diethylenetriamine, triethylenetetramine, 3-dimethylaminopropylamine, and trimethylhexamethylenediamine; (2) cycloaliphatic polyamines, e.g., isophoronediamine and 3,3'-dimethyl-4,4-diaminodicyclohexylmethane; (3) aromatic amines, such as 4,4'-diaminodiphenylmethane, m-phenylene diamine, and 1,3-xylylene diamine; (4) dicyanodiamide; (5) triglycidyl isocyanurate, an epoxy compound that may be used as an epoxy-resin hardener; and (6) additives in epoxy accelerators, such as hexavalent chromate.

CONCLUSIONS

No one chemical can be used to screen for sensitization to the many different epoxy hardeners. Extensive patch testing may be required to reveal the hardener that has caused the allergy. The hardener, 2,4,6-tris-(dimethylaminomethyl)phenol (tris-DMP), is a new sensitizer. To verify ACD caused by tris-DMP, patch-testing at 1% in petrolatum is suggested.